West Nile Egg Donor Testing

West Nile Virus Screening Underway At TWEB

West Nile Virus Egg Donor Screening

West Nile Virus (WNV) is an arbovirus spread principally by Culex mosquitos that occur widely in the continental US. Mosquitos pick up the virus from infected birds and transmit it to other birds, mainly in the summer.

After being bitten by an infected mosquito, most people with West Nile Virus are asymptomatic or mildly symptomatic with a flu-like illness with or without a rash (West Nile fever). However, encephalitis (WNE) or meningitis (WNM) may follow infection, with significant morbidity and mortality rates. A US outbreak in 2012 caused 286 deaths. Recovery from even milder cases may be lengthy with physical and cognitive/mental symptoms.

First noted in Uganda in 1937, and highly prevalent with serologic testing in Africa and India, the disease was detected in North America in 1999. Human-to-human transmission through transfusion was noted and US blood banks began testing in 2003.

Under the guidance of the US Food and Drug Administration (FDA), “establishments must perform donor testing to adequately and appropriately reduce the risk of transmission of relevant communicable disease agents and diseases.”

Although donation of human oocytes has never been shown to cause infectious disease, oocytes fall under FDA jurisdiction under Human Cells, Tissues, and Cellular and Tissue-Based Products (HCT/Ps) regulations. West Nile virus was added to the list of recommended screening within the last year.

Oocyte donor testing involves a questionnaire regarding blood transfusion, rashes and febrile illnesses as well as testing a donor’s blood at specific intervals before oocyte retrieval. Nucleic acid testing (NAT) has higher sensitivity and specificity for most viruses than antibody tests that may be easier to implement for screening large populations. The FDA has authorized specific NAT assays that are now widely commercially available.

The World Egg Bank stays current with all suggested and recommended FDA protocols and has implemented WNV testing, along with HIV, Hepatitis B & C, and other infectious disease testing such as Chlamydia. We have undergone frequent inspections by the FDA and have had no major citations.

Clinics which do not perform oocyte or sperm donor screening and stimulation are exempt from FDA inspections. The onus of regulation and inspection falls upon the organizations, such as The World Egg Bank, doing the donor screening and testing.

from The World Egg Bank http://www.theworldeggbank.com/blogs/west-nile-egg-donor-testing/

Shipping Ooctyes

Our Proprietary Process For Shipping Oocytes

At The World Egg Bank, we strive to make our shipping and receiving procedures as straight forward as possible. For this reason, our shipping procedure starts days to weeks ahead of the planned shipping date. As soon as a patient has finalized the details of obtaining their eggs, an email is sent from the shipping team to the receiving clinic detailing the patient’s name, selected donor number, and date that we can ship the order, along with an estimated delivery date. This email asks for confirmation from the clinic that the proposed date(s) work, the shipping address is correct, and that the list of embryologists verified to perform our warming technique is up to date. Once we receive confirmation that all information provided is accurate and approved, the shipment is placed on the shipping team calendar and the proposed date is entered into the recipient’s file on our custom-built database.

Scheduling Shipments

To streamline the process, while managing clinic and patient expectations, we’ve learned how to limit the amount of potential weekend-time that the tanks are in transit by scheduling domestic shipments to Tuesdays and international shipments to Thursdays. The day prior to shipping, all paperwork and airway bills are created and the tanks to be used are filled with liquid nitrogen to ensure that they are charged and ready for their journey. The day of shipment, all orders are carefully packed and ready for pick up by 11:00 AM. This level of detail ensures a consistent process for every shipment that leaves our facility, thus nearly eliminating any unforeseen variables.

Verifying New Clinics

The process differs slightly for new clinics vs verified clinics. For clinics who have not worked with us before, we require them to go through our “verification process.” This is akin to training, but is limited to understanding and proper technique for our warming protocol only. Final authorization for performing any warming is left to the discretion of the laboratory director. When initially contacting a new clinic, a small packet of paperwork is sent that explains the details of our process, asks for a short equipment list to be filled out to ensure the clinic has the proper equipment to perform the task, and for information on the nearest airport and travel accommodations for our verifying embryologist. Once we receive this paperwork, the warming date can be established. Two weeks prior to the warming date the eggs are shipped from our facility. In that shipment is a packet containing a letter detailing the verification procedure, extra warming dishes, extra warming media, and a blank vitrification device. In the tank with the oocytes is one practice oocyte per embryologist being verified.

While sounding complex, these procedures are highly coordinated. Our top priority in the shipping department is to ensure success in transit. By putting these procedures in place, we have perfected minimizing issues related to the transit of oocytes.

from The World Egg Bank http://www.theworldeggbank.com/blogs/shipping-ooctyes/

Caring For Our Egg Donors

What Donors Can Expect From Our Staff

At The World Egg Bank (TWEB) we are fortunate enough to work every day with some of the most thoughtful and generous young women; our Egg Donors. We strive to provide the donors with a warm, relaxing, and welcoming environment. Our lobby is reminiscent of a spa, rather than a medical office. Please take a virtual tour of our egg bank and egg retrieval facility:

The staff at TWEB works with donors from start to finish. Beginning with the interview process, we spend time with these women, explain each step of the donation process to them and answer all questions they might have. We then guide her through the screening process including lab work, evaluations, and consultations.

Once a donor is selected for a cycle, the nursing staff will work “hand-in hand” with the donor through all her ultrasounds, blood draws, and injections. Throughout the process we develop a great relationships with our donors.

We have found that consistent and reliable communication is imperative and always having an open line of communication via phone, email, text or in person with the nursing staff makes our donors feel more at ease during this sometimes intimidating process.

When it is time for Egg Retrieval, the nursing staff is with the donor from the start of anesthesia until they are awake and ready to go home. A hand to hold and a smiling face are tremendous comfort to the donors as they drift off to twilight sleep. Providing a positive and tranquil environment is our focus. Our walk to their car with their driver always ends in a big hug. We are with them every step of the way.
Our donors are truly remarkable women and we value each minute we spend with them.

from The World Egg Bank http://www.theworldeggbank.com/blogs/caring-for-our-donors/

Egg Retrieval – What To Expect

Donating At The World Egg Bank

You will arrive at The World Egg Bank (TWEB) at your specified time, dressed in a comfortable outfit of your choosing. Our donor coordinator, Andrea, will be there to greet you and have your final paperwork ready for you to complete. Once paperwork is completed, you will be brought back into the retrieval room, where Andrea and nurse Lisa will prepare you for the procedure. Our anesthesiologist will put you under twilight sedation, comparable to getting your wisdom teeth out.

Egg Retrieval Procedure

The procedure itself takes around 15-30 minutes and is minimally invasive; no incisions, no scaring. An ultrasound guided needle is inserted through the vaginal wall to retrieve the eggs. Once the procedure is over, you will be moved into a recovery room to rest before leaving. You will not be able to drive, so please have someone drive you to and from TWEB. If you are an out of state donor, we will arrange a driver for you. Upon leaving, you will receive a thank you bag for your generous donation, which includes your reimbursement check.

Recommended Post Care

When you arrive home or back to your hotel, we highly encourage you to rest for the remainder of the day. Feel free to sleep, binge watch Netflix, snack on your favorite food, and just enjoy the rest of the day. You might experience some minimal side effects similar to PMS, such as cramping, bloating, fatigue or nausea. Every donor is different and these vary person to person.

If you need anything following your donation or have questions or concerns, our team at TWEB is always available to assist you.

from The World Egg Bank http://www.theworldeggbank.com/blogs/egg-retrieval-what-to-expect/

Using Frozen Eggs To Successfully Achieve Healthy Pregnancies

It has been nearly three decades since the first live birth was achieved using frozen eggs. Since that time, many advances have been made in the field of reproductive medicine, most notably the introduction of modern vitrification (fast freezing) techniques. Numerous studies have been published confirming the outcome of cycles using frozen eggs to be just as favorable as using fresh eggs.

Recent advances in the supporting technology for reproductive medicine have allowed for us to take a closer look at the development of the embryo. In a recent study, published in the September 2017 edition of the Fertility and Sterility Journal, embryo development was evaluated utilizing time-lapse analysis and morphokinetic parameters (physical features and biological activity parameters) for assessment of embryo quality. The study revealed that there was on average only a 1-hour delay in the formation of the blastocyst (mature stage of embryo development, ideal for embryo transfer); that the quality of the embryo was not impaired; and that there was no difference in the quality, implantation rate, and clinical pregnancy rate.

This study adds to the growing body of evidence of the safety and equivalency of using frozen eggs to successfully achieve healthy pregnancies, and here at The World Egg Bank, we continuously pursue the highest standards of excellence in providing quality donor eggs for our recipients.

from The World Egg Bank http://www.theworldeggbank.com/blogs/using-frozen-eggs-to-successfully-achieve-healthy-pregnancies/

Under the Microscope: An Examination of Embryo Transfer Technique

Assisted reproductive technology (ART) has allowed millions of couples to bear children over the last 40 years, but it remains less than 100% successful. Attention has focused on improving ovarian stimulation, insemination methods, culture techniques, and screening for genetic status of resulting embryos. These measures have increased pregnancy outcomes year by year, allowing for single embryo transfer as the standard approach in many instances.

It is indisputable that the embryo transfer (ET) itself is a vital component of the process. It seems however that the technical aspects of embryo transfer have been “below the radar” for many ART practitioners. We have known that there is a learning curve and that some operators have consistently better outcomes than their colleagues in the same practice. One concern is many fellows in US training programs perform very few ET procedures, leaving new graduates to learn on their patients. After recognizing this, the American Society for Reproductive Medicine (ASRM) commissioned the development of an ET trainer device, a virtual reality based simulator. A recent study showed that use of the simulator shortened the learning curve considerably for fellows (Embryo transfer simulation improves pregnancy rates and decreases time to proficiency in Reproductive Endocrinology and Infertility fellow embryo transfers. Heitmann, Ryan J. et al. Fertil Steril, 2017; 107, 1166 ).

Many standard techniques of ET have never been rigorously evaluated, and when they have, the results have been somewhat inconsistent. ASRM formed an Embryo Transfer Advisory Panel, seeking to improve performance of the ET by utilizing a combination of literature search and surveying Society for Assisted Reproductive Technology (SART) member practices regarding their use of various procedures. The findings have recently been published (ASRM standard embryo transfer protocol template: a committee opinion. Penzias, Alan et al. Fertil Steril, 2017; 107, 897 – 900).

The conclusions are slightly surprising and definitely worth review. Turns out that only a handful of the component steps of the ET practice are proven to be beneficial, for example transabdominal ultrasound guidance and use of a soft catheter. A few commonly employed practices such as, bed rest after ET and powder-free gloves have been demonstrated not to be beneficial. The benefits of a number of other practices are still unclear.

After review, the Practice Committee issued guidance for the basic approach to ET. The Committee also reminds us of the many benefits of standardization of clinical methods, recommending that each ART program develop a set of standard procedures to reduce risk and to optimize outcomes. It is time well spent for IVF practitioners to review these guidelines and discuss them with their clinical teams.

from The World Egg Bank http://www.theworldeggbank.com/blogs/under-the-microscope-an-examination-of-embryo-transfer-technique/

Understanding Egg Donation – Anonymous vs. Full Disclosure

The World Egg Bank offers two different types of disclosure to our donors: anonymous or full disclosure.

What is anonymous?
Anonymous egg donations apply to United States recipients and in other regions where by law egg donation remain anonymous. In these cases the only information about the egg donor shared with the recipient is; age, ethnicity, medical his tory, family history, childhood or recent photographs, education, etc. Identifying information such as name, address, contact information is never released to the recipients.

What is full-disclosure?
Full-disclosure is an option for our donors who agree to donate their eggs to UK and Australian recipients. In these regions, anonymous donations are no longer allowed so that people born from donated gametes are able to trace their biological history if they desire. Agreeing to full disclosure means that the donor is open to the possibility that if a child is born from her donation, the child might be able to contact her. By doing so the egg donor is opening herself to being an eligible donor for about 50% of The World Egg Bank’s current recipient’s in full disclosure regions in addition to the recipients from anonymous regions.

Legal Implications of full-disclosure: Donors, recipients and the individuals born as result of the donation, have legal rights and responsibilities.

• Individuals born from donor procedures have a right to obtain identifying information of their donor, once they reach the age of 18.
• As a donor you do not have any legal responsibility for the people/person born as result of your donation.
• All donors and recipients are required to have counselling before proceeding to donor treatment.
• If you and the recipient agree to the release of identifying information, contact, and/or information exchange can occur before the child is 18 years of age.

Donor’s identifying information will be kept in a government registry in the region the recipient/intended parents reside/where the child is born. If a child whom resulted from donation chooses that they want to have access to the identifying information of the egg donor they must apply through the government registry and go through counselling to get approved access.

If the child is approved access the donor would be contacted, offered counselling and asked if she is comfortable giving consent to the release of information.

Keep in mind that just because a donor agrees to full-disclosure does not guarantee their eggs will be sold to recipients who reside in full-disclosure regions. It also does not guarantee that if their eggs are sold to recipients in these regions that a birth will occur or that a child born from a donation would contact their biological donors.

from The World Egg Bank http://www.theworldeggbank.com/blogs/understanding-egg-donation-anonymous-vs-full-disclosure/